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BASIC TRAUMA LIFE SUPPORT FOR FIREFIGBTERS

ASSESSMENT OF THE BASIC LIFE SUPPORT (BLS) SKILLS OF


MEDICAL STUDENTS AS PART OF THE MBBS FINAL
EXAMINATION
FWhimster.
P Kopelman, J Dacre, G Holsgmve, S Gooda, St
Bartholomews and the Royal London School of Medicine and Dentistry,
lomdon, England
Objectives: To astzas practical akills in BIS as part of the Final MB BS
examination.
Metbodr: 199 atudenta sitting a Pilul MB BS cxaminacion undertook an
Objective Struchld CIiical Examb&on (OSCE) to assess practical
clinical akills. The BLS station required atudenta to ~EICS a collapsed
patient (L.aerdal SkillMeter) and commenceone-person BLS. Performance
was apsesstdover two cycles of BLS using a M-point checklist designed to
test knowledge of the ABC sequenceand pmctical akills.
Raaultl: The 199 students amesaed were the product of two merged

AiiDRBW KENT
GREATER MANCHESTER FIRE SERVICE, HOPE HOSPITAL, SALFORD
MANCHESTER ADVANCED LIFE SUPPORT GROUP, MANCHESTER
who have an immediate
ORJRCTIVES: Train firefighters
response capability.
in the use of life
supsort &ills.
both
cardiac and- trauma:
To assess and ms.intsl~life
untiltbe
arrival
of the paramedical
esrvice.
MFXHODS: Establish
s three tier training
progremme in basic
cardiac and trauma csre.
The final
tier of training
establishes
the fire fighter
as a trauma technician.
This
includes a one week hoapital
placement in the emergency room.
of six local hospitals.
Establish
s self audit system
to determine
use of skills
and
skill
retention
within
the fire fighters.
RESULTS: By January 1996 230 one day technicians
will have
completed the course. following
one year from conception.
40 trauma technicians
have completed the full module courts.
In total one ninth of the brigade have been trained.
26
casualties
have had airways cleared by the trained
fire
fighters.
90casualtiea
have had their cervical
spine
immobillsed.
7 cardiac arrests
have been initially
msnaged
by the fire fighters.
(XINCLIISTON: A training
progrsmme .to allow fire fighters
to
s casualty
until
the arrival
of the
assess and maintain
paramedics is apparently
effective
when the fire fighter
is
left to fill
the therapeutic
vacuum whilst
awaiting
the
arrival
of qualified
medical help.

medical schools: 111 had commeoced their medicsI training at School A and

88 at School B. The maximum possible mark was 20. The range of marks
awarded was 6 - 20 with a significant difference @=O.Ol) between the
mean scare for School A studentsof 13.6 (68%) and for School B shdcnts
of 14.7 (73.5%). 172 studentsachieved the Passmark of 11 (55%) on the
BLS station. 118 students scored at least 14 (70%). There was a
significant difference hehvcen t!! prucfiml skills of the two groups of
students. Three students failed the OSCE, all three failed the BLS statiun.
Conclusion: BLS skills have significantly improved since Skinner et al
assessedthem in 1985 6t 19W and tbii can be attributed to the increased
emphasis on the subject in the cuniculmn.

EMI hospitals now employ

Resuscitatlor~Tmininp Officers with an input to medical student education.


In acidltion, School B arudentshad gained extra practical experience through
attending their hospitals community resuscitation training programme
during their first and fourth years. The assessmentof practical skills,
including BLS, in final medical examinations is strongly recommended.
This subject must be taught, and practisad regularly, during undergraduate
training.
Reference?: 1. Skinner DV, Camm Al. Miles S. CPR skills of
preregistration house officers. BMJ 1985;290:1549-50. 2. Morris F,
Tordoff SO, Wallis D. Skinner DV. CPR skills of preregistration house
officers: five years on. BMJ 1991:302:62x5-7.
O-12

O-10
OK (CPU)

SKILLS

II OP pft-rog

OP

TllAIttIUG
S.PARBOTEEAH,M.CREIG,

D.ELLIOTT,

School

of

Health

Portsmouth,

ants,

L.WILKS,
of

university

Studies,

~ntraductian:~hr

effectiveness

support
(BLS)
considereblv.

Portsmouth

England

skills
This

of

bas:c

among nurses
varies
longitudinal
comparative

life

srlldy

seeks
to
identify
and
1:6
teacher
Methodalogy:BLS
receiving
thirteen
curriculum,
were

the
effect
of
regular
practice
student
ratio
on BLS performance.
skills
of
student
nurses
(n-S?-)
hours
of
CPR training
in
the
evaLuated
and
compared
to a study
group
(n=6)
who received
additional
BLS practice
consisting
of
one
hour,
bi-monthly,
over
a three
In
accordance
with
current
European
year
period.
guidelines
for
BLS testin::,
the
following
skills
were
considered
mandatory
for
effective
CPR;
assessment
of
responsivenass,
airway,
breathing

call

and circulation;
performance
(ALS);
compression
and
depth.

ConLLol

advanced

lite

and

support

chest
ratio,

rate

Percentage
of atudcnts
passing each
phase of the test
ECC O"C!CC.II
AsseaaalruL
ALS Call
A

Results:

Study

for

of
ventilation
correct
position,

using

Group

100%

100%

100%

79%

44%

3%

GLP

COPCaiOPr3:
BLS training

The
for

Future
teaching

should
regular,

tratiing
and

results
student

demonstrare
nurses
is
LOCUS
frequent

on

small
practice

100x

P.3SS
100%

19%

5%

ttl*t
CYrrent
ineffective.
group
on

manikins

LIFE SUFPORT TRAINlNG IN THE FIRST YEAR OF


SECONDARY SCHOOL
Carolvn Lester, Peter Dormelly. Centre for Applied Public Health
Medicine, University of Wales College of Medicine, Cardiff,
Wales, U.K. Clive Weston, Pinderfields Hospital, Waketield,
England, U.K.
Objectives. To investigate the feasibility of teaching
cardiopulmonary resuscitation (CPR) in the first year of secondary
school. and the effect of pupil instructors (peer tutoring) on skills
and self perception of ability.
Method.
Of nine first year mixed ability, mixed sex classes(age
11-12 years) four (106 pupils) were htstructed by teacher only and
five (137) by teacher assisted by older pupils. Before training
each child completed a registration form collecting demographic
details and information on previous CPR training and family
members with heart problems. Post training pupils were tested in
practical skills and completed questionnaires on CPR theory.
attitude and willingness to perform in an emergency.

Results. Forty-eight per cent were aware of one or more relatives


with a heart problem and thirty-six per cent had some previous
knowledge of CPR. Post instruction skill testing showed no
significpnt difference between teaching methods. but 81% of girls
achieved marks of 90% or more compared with 57% of boys
(p < 0.001). Of the girls 75 % believed that they would be capable
uf saving a life in an emergency compared with 55% of boys
(p<O.Ol).
Those instructed by teacher only showed greater
confidence with 74% who thought they would be able to save a
life, compared with 56% instructed by teachers and older pupils
(pCO.01). but overall 95% believed that everyone shontd he

instructed in CPR.
Conclusion. It is feasible to teach CPR in the first year of
wcondary school using peer Ntoring

may he detrimental to confidence.

but instruction by older pupils